Good Samaritan Health System in Lebanon Wednesday laid off 22 employees and announced it wouldn’t be filling another 28 vacant positions. The hospital says the Affordable Care Act and the federal budget sequestration partially are to blame in the change.

William Mulligan, spokesman for Good Samaritan Health System, said the Affordable Care Act, otherwise known as Obamacare, has caused payment reductions that are impacting health systems. It’s also required the health system to invest in expensive information technology systems for electronic medical records.

The federal cuts through sequestration are expected to cut reimbursements to Good Samaritan by about $2.5 million in the next fiscal year.

Mulligan said the Affordable Care Act is making the health system go through a transition where the end goal is to move from caring for patients in an inpatient setting to an outpatient, primary care setting.

Part of the rational for doing that is to attempt to improve the quality of life for patients and communities, Mulligan said.

But, from a revenue standpoint, payments from patients cared for in an outpatient setting generally are less than payments from patients being cared for in an inpatient, hospital setting. That, in turn, reduces the amount of money coming to the hospital.

“There are going to be long term benefits from providing care to people in a primary care setting as opposed to when they need a hospitalization,” Mulligan said.

“And that goal is laudable. The steps that it’s going to take to get from where we are today until then are going to present some challenges along the way.”

Mulligan said other factors tied to the economy are affecting the hospital’s bottom line.

While revenues for operations came in at $171 million last fiscal year — between July 1, 2011 and June 30, 2012 — the hospital incurred $20 million in charitable and uncompensated care. The hospital provides charitable care to patients who meet certain criteria, and it pays for uncompensated care mainly when patients don’t pay their bills.

The hospital expects those expenses will increase in future years, Mulligan said.

Of the 22 employees laid off Wednesday, most worked in administrative or support areas, according to a statement from the hospital. The hospital does not expect the reorganization to impact patient care.

Good Samaritan will provide severance packages and outplacement assistance to all employees affected by the changes, according to its statement.

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